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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Mrunal Bhoir
Article Info: Published on : 15/07/2025
Impact Factor : 1.013
A Cross-Sectional Study Of Jihwa Pariksha In Prameha With Special Reference
To Diabetes Mellitus
Dr. Mrunal Bhoir
1
, Dr. Jai Kini
2
, Dr. Kavan Zankat
3
, Dr. Avani Sanghani
4
1
Dr. Mrunal Bhoir (Associate Professor, PG and PhD Department of Roga Nidana evum Vikriti Vigyan,
Parul Institute of Ayurveda, Limda, Vadodara, Gujarat-391760, Ph.D. Scholar Dr. G. D. Pol Foundation’s
YMT Ayurvedic Medical College & Hospital Institutional Area, Sector 4, Kharghar, Navi Mumbai
410210)
2
Dr. Jai Kini (Research director & Professor of Roga Nidan Evum Vikriti Vigyan, Dr. G. D. Pol
Foundation YMT Ayurvedic Medical College & Hospital Institutional Area, Sector 4, Kharghar, Navi
Mumbai - 410210 )
3
Dr. Kawan Zankat (Assistant Professor of Roga Nidan Evum Vikriti Vigyan, Pioneer Ayurvedic College
and Hospital, Gujrat Ayurved University, Sayajipura Village,Vadodara, Gujrat-550019 )
4
Dr. Avani Sanghani (Final year PG Scholar, PG and PhD Department of Roga Nidana evum Vikriti
Vigyan, Parul Institute of Ayurveda, Parul University, Limda, Vadodara, Gujarat- 391760)
Cite this article as: - Dr. Mrunal Bhoir (2025) ; A Cross-Sectional Study Of Jihwa Pariksha In Prameha With Special Reference
To Diabetes Mellitus ;Inter.J.Dignostics and Research 2 (4) 72-79, DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 2 395
G
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Abstract
Acharya charak has described that srotamsi are channels which transport the Dhatu (asthayi or
poshya dhatu) which are subjected to transformation. The term srotas refers to channels or systems within
the body through which tissues are developed, materials are metabolized, secreted, or transported.
(SRKR,
2008)
Swedavaha srotas is one among the thirteen types of srotas, which flushes out the body waste in the
form of sweat. In 'Bhanumati' tika, acharya chakrapani said, that 'jalamahabhoot' are predominantly
present in sweda. Acharya charak stated in sharir sthan, that Jala, lasika and sweda is in ten Anjali
Pramana. Swedavaha srotas are pathologically important because any deformity in this srotas causes
excessive perspiration or no perspiration and other symptoms related to this srotas. In various diseases, for
example- Kustha, Pandu, sthaulya, prameha, Vatrakta, Jwara etc., vitiation in swedavaha srotas causes
different Rupa and Purvarupa obstruction in swedavaha srotas.
[2]
In diagnosing and understanding
Prameha in patients with Swedavaha Srotodushti vikar, Jihwa Pariksha, or tongue examination, serves as
a valuable diagnostic tool. This examination involves observing various features of the tongue, such as its
color, coating, presence of fissures, texture, and movements. By assessing these characteristics,
practitioners can gain insights into the patient's overall health, including potential imbalances in the
Swedavaha Srotas and related conditions. Aim: To conduct Jihwa Pariksha in patients with Prameha
(diabetes mellitus). Objective: To study changes in Jihwa manifested in patients of Prameha (diabetes
mellitus). Material & Methods: Jihwa of 26 patients of Prameha (diabetes mellitus) are observed for color,
coating, fissures, texture and movements. in Prameha coating is observed on the Jihwa, it was seen that
maximum patients have coating present whether it is thin, thick or patchy.
Keywords: Jihwa, swedavaha Srotodushti Vikar, Prameha, diabetes mellitus, Tongue examination,
Ashtavidha Pariksha.
Introduction:
Acharya Charaka highlighted the critical
importance of Rogi Pariksha, emphasizing that a
thorough examination of the patient must precede
any treatment, with the physician's work
commencing only thereafter. According to the
Sushruta Samhita and Vagbhata, srotas are likened
to the very fine channels and pores found in a lotus
stem. These channels facilitate the circulation of
rasadi and poshya dhatu throughout the body,
delivering essential nutrition.
[3]
Acharya Yog-
Ratnakara introduced the concept of Ashtavidha
Pariksha, an eightfold examination in Ayurveda,
essential for identifying the various causes of
diseases. This eightfold examination includes Nadi
(Pulse), Mootra (Urine), Malam (Fecal matter),
Jihwa (Tongue), Shabdam (Voice of patients),
Sparsham (Touch), Druk (Eyes & Vision), and
Akriti (General body build). Among these methods,
Jihwa Pariksha is particularly significant in Rogi
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Pariksha. Ayurveda regards the tongue as a map of
the body, where each feature reflects a specific
aspect of the body’s constitution or imbalance. The
appearance of the tongue, including its coating and
color, serves as a diagnostic tool to understand the
predominant imbalances within the body.
[4]
Aacharya charak has described that sweda is
fraction of udaka which comes out through skin
pores on exposure to heat. The quantity of udaka is
10 Anjali Pramana,
[5]
and is distributed all over the
body; it has different names as per location and
function. Here Acharya charak is referring to the
thermoregulation mechanism. When there is
increase in body temperature on exposure to the
heat or due to other reasons, the thermoregulatory
mechanism operates to maintain the body
temperature and sweating is the most important
mechanism of body to lower down the temperature.
Excretion of large quantity (during short interval of
time) of turbid urine is called as prameha.
[6]
Prameha is also defined by the term “Avila-
Prabhuta- mutra.
[7]
Prameha is a term in Ayurveda
that refers to a group of metabolic disorders,
particularly those involving excessive urination. It
is broadly categorized into different types based on
the dominant dosha involved (Vata, Pitta, or
Kapha). In the context of Ayurveda, the concept of
"Srotas" refers to the body's channels or pathways
through which various substances such as nutrients,
waste, and doshas are transported. Prameha, often
compared to diabetes mellitus in modern medicine,
is characterized by abnormalities in the metabolic
processes, leading to the impaired functioning of
various systems in the body. Among the various
Srotas (body channels) described in Ayurveda,
Swedovaha Srotas pertains to the channels
responsible for the production and excretion of
sweat.
[8]
Swedovaha Srotas plays a crucial role in
maintaining the body's homeostasis by regulating
body temperature and aiding in the elimination of
waste products through perspiration. When these
channels are affected in Prameha, it results in an
imbalance that can manifest in various symptoms
and complications.
Need Of Study:
Prameha, as described in Ayurveda, encompasses a
variety of metabolic disorders, which includes
conditions analogous to diabetes mellitus (DM) in
modern medicine. Diabetes mellitus is a chronic
condition characterized by hyperglycemia due to
defects in insulin secretion, insulin action, or both.
The prevalence of DM is increasing globally,
leading to significant health challenges, including
cardiovascular diseases, neuropathy, nephropathy,
and retinopathy. Early diagnosis and effective
management are crucial in mitigating these
complications. Diabetes mellitus often remains
undiagnosed until significant complications arise.
Jihwa Pariksha can serve as a non-invasive, cost-
effective preliminary diagnostic tool, potentially
identifying early signs of Prameha.
Tongue examination is a simple yet vital tool in
determining the presence of Ama (toxins), the
stages of doshik imbalance such as Sama (with
toxins) and Nirama (without toxins) states, and the
conditions of Vriddhi (aggravation) and Kshaya
(depletion) of the doshas.
[9]
It serves as a reflection
of the body’s digestive, nutritional, and metabolic
status, providing insights into internal bodily
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functions. Despite its significant role as an
examination method in Ayurveda, tongue
examination lacks robust scientific validation.
However, in diagnosing conditions like Prameha
(diabetes mellitus), tongue examination could prove
to be highly effective. This study aims to
investigate the changes in the tongue associated
with Prameha (diabetes mellitus), contributing
uniquely to the Ayurvedic literature and enhancing
its diagnostic practices.
Aim & Objective:
Aim: To conduct Jihwa Pariksha in patients of
Prameha with special reference to diabetes
Mellitus.
Objective: To conduct and analyse changes in
Jihwa manifested in patients of Prameha with
special reference to diabetes Mellitus.
Materials & Methods:
1. Sources of data:
(A)
Literary Sources –
• All Available Ayurveda Texts,
• All Available Modern Books,
• Reviewed Research Articles,
• Research Papers,
• Authenticated Internet Sources.
(B)
Clinical Sources – Patients were taken from
OPD & IPD from Parul Ayurved Hospital,
Parul Sevashram Hospital, Khemdas Ayurved
Hospital, Waghodia, Vadodara, Gujarat.
Subjective criteria: Classical lakshanas of
Prameha Vikaras
[10]
were assessed.
Type of Study: Observational study.
Details of Clinical Study: An observational trial
on 26 diagnosed patients of Prameha (diabetes
mellitus) was conducted for a research study.
Data Collection: Separate case paper Performa had
been prepared and observations were noted.
Study duration: 18 Months
IEC Certificate No: PU/PIA/IEC/07/2023/270
Inclusion Criteria:
1. Selection of patients were done irrespective
of gender, socioeconomic status.
2. The diagnosed patients with lakshan of
Prameha (diabetes mellitus) between the
age of 18-60 years were included in this
study.
Exclusion criteria:
1. Patient with local tongue infection and
congenital anomalies were excluded.
2. Patients having major ailments of other
systems.
Observation:
The study analyzed various tongue (Jihwa)
characteristics in individuals with Prameha. The
key observations are as follows:
1. Tongue Color:
The majority of participants (92.30%) had a
normal tongue color.
Only 7.69% exhibited abnormal
discoloration.
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2. Tongue Coating:
None of the participants had a
completely uncoated tongue.
A thin coating was observed in 38.46%
of cases.
Patchy and thick coatings were each
noted in 30.76% of individuals.
3. Tongue Fissures:
About 34.61% of individuals had no
fissures on the tongue.
Another 34.61% exhibited 1–3 fissures.
Fissures ranging from 4–10 were found
in 23.07% of cases.
More than 10 fissures were observed in
7.69% of individuals.
4. Tongue Texture:
More than half of the participants
(53.84%) had a normal tongue texture.
Mild roughness was reported in 42.30%
of cases.
A hard and irregular texture was found
in only 3.84% of individuals.
Key Findings:
The most noticeable variations in
Prameha patients were observed in
tongue coating, fissures, and texture.
Thick and patchy coatings were
common, indicating potential digestive
imbalances.
The presence of multiple fissures and
mild roughness suggests possible
metabolic disturbances.
Tongue color remained unaffected in
most individuals, showing no significant
discoloration.
Discussion:
Age: In the present study it is observed that the
greater number of patients were from age group 41-
50 & 51-60 years. In this age maximum people
follows the sedentary life. In this age group most
patients were job and worker, life style, food habits
and daily routine had involvement in producing
diseases.
Gender: It was observed that maximum 55% of
patients are Males and 45% patients are Female.
The reason behind the male ratio high is affected by
certain factors such as age, occupation, lifestyle,
food habits etc.
Diet : It was observed that 58% of the patients
were vegetarian. This might be due to the
traditional vegetarian dietary habits and among
these most of the patients were taking Viruddha
Ahara, Mamsahara, Ushna, Tiksha Ahara etc.
which aggravates Pitta Dosha and cause
Swedavaha Srotodushti.
Addiction :13.33% were having no any addiction,
72% had the addiction of tea,14.66% had other
addiction (smoking, alcohol, tobacco).
Appetite :It was observed that 39.33% had Poor
Appetite, 54% had medium appetite, 6.66% had
Excessive appetite out of 150(100%) patients in
Prameha.
Deha Prakruti :In the Present study It is observed
that Maximum number of patients were Kapha
Pradhana Tridosha Prakruti cause for Prameha
Roga in Swedavaha Srotodushti patients.
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Changes On Jihwa in prameha:
Colour: Most of the patients have normal colour
of tongue (pink) i.e. Out of total patients of
Prameha 24(92.30%) had normal color of Jihwa,
while 2(7.69%) had abnormal color of Jihwa.
Coating: Prameha being a kapha pradhana
tridoshaja vyadhi, due to the kapha pradhanta and
Meda dhatu; mentioned as the moola sthana of
swedavaha srotasa, due to the apakwa ahara rasa
the meda Dhatwagni gets vitiated which ultimately
results in the formation of aama Utpatti and this
can lead to coating over the tongue.
[11]
Most of
coating in diabetic patients is usually a result of
poor oral hygiene as food and bacteria accumulates
on the dorsal aspect of tongue.
Coating : Changes On Jihwa In Prameha
Image A: of Thin coating
Image B: Thick coating with
4 to 10 fissures
Fissures:
Maximum patients were found with
multiple fissures in this disease. Atiswedanama
was the common lakshana found in the patients
of Prameha. atiswedanama is responsible for
dryness of body which is due to the vitiation of
ruksha guna of vata. This might lead to the
presence of fissures on the tongue (sphutita
jihwa) and mild rough texture of tongue.
[12]
Fissure : Changes On Jihwa In Prameha
Image A: More than 10
fissure
Image B: 4-10 fissure
Table No.1 : Distribution based on changes in
Jihwa according to Prameha Roga
Sr.
No
Prame
ha
Changes in Jihwa
(Total = 26)
1.
Color of
Jihwa
f
%
Normal
24
92.3%
Abnormal
2
7.69%
2.
Coating on
Jihwa
f
%
No Coating
0
0
Patchy
Coating
8
30.76 %
Thin
Coating
10
38.46 %
Thick
Coating
8
30.76%
3.
Fissure on
Jihwa
f
%
No Fissure
9
34.61 %
Fissures 1 3
in Number
9
34.61 %
Fissure 4-10
in Number
6
23.07 %
Fissures
more than
10 in
Number
2
7.69%
4
Texture on
Jihwa
f
%
Normal
14
53.84 %
Mild Rough
11
42.30 %
Hard
irregular
1
3.84 %
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Conclusion:
Statistically, in Prameha coating is observed on
the Jihwa, it was seen that maximum patients
have coating present whether it is thin, thick or
patchy. From this study, it can be concluded that
there is a significant relationship between Prameha
Roga and changes in the Jihwa, both clinically and
statistically. The presence of coating, fissure, and
texture alterations on the Jihwa indicates a
correlation with Prameha Roga. The coating on the
Jihwa, attributed to the generation of Mala Rupa
Kapha due to Ama Rasa Dhatu or Rasvaha
Srotodushti, along with Vata affliction, which may
lead to fissures, supports this assertion. Vata
Dosha's Rukshata quality contributes to the drying
of Jihwa moisture, resulting in a mild rough
surface
[13]
These findings underscore the
significance of evaluating Jihwa changes in
diagnosing and understanding Prameha Roga with
special reference to Diabetes Mellitus.
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chapter, sharirsthan in Murthy
Shrikant KR, Susruta Samhita Vol.I,
English translation Chaukhamba
orientalia, Varanasi, Reprint edition;
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